Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,445.41 / $1,445.41 / $1,445.41	Facility		$1,445.41	$1,445.41	$1,445.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,005.78 / $1,445.41 / $1,445.41	Professional		$1,005.78	$1,445.41	$1,445.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,830.78 / $7,632.39 / $13,901.10	Facility		$3,830.78	$7,632.39	$13,901.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,404.42 / $2,530.96 / $3,416.81	Professional		$2,404.42	$2,530.96	$3,416.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,333.23 / $1,370.99 / $1,645.13	Facility		$1,333.23	$1,370.99	$1,645.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,024.78 / $2,024.78 / $2,024.78	Professional		$2,024.78	$2,024.78	$2,024.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,637.27 / $1,637.27 / $1,637.27	Facility		$1,637.27	$1,637.27	$1,637.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,637.27 / $1,637.27 / $2,934.00	Professional		$1,637.27	$1,637.27	$2,934.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,445.41 / $1,829.01 / $1,829.01	Facility		$1,445.41	$1,829.01	$1,829.01
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,445.41 / $1,829.01 / $2,846.70	Professional		$1,445.41	$1,829.01	$2,846.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $980.77	Professional		$30.00	$30.00	$980.77
United Facility/Professional Facility Modifier Low / Median / High Price $1,366.91 / $1,366.91 / $1,366.91	Facility		$1,366.91	$1,366.91	$1,366.91
United Facility/Professional Professional Modifier Low / Median / High Price $852.74 / $1,209.97 / $1,691.14	Professional		$852.74	$1,209.97	$1,691.14